Drugs, Substances and Lab testing Consultations
The College has changed the way in which we address the drugs, substances and laboratory testing that are authorized to NDs in Ontario. Rather than issued a periodic call for submissions, the College will now welcome submissions at any time.
Drugs and Substances
Under Ontario law, NDs are authorized in regulation to administer certain substances by inhalation and injection, the latter including by intravenous infusion therapy, and to prescribe, dispense, compound and sell specific drugs. Authorization is in the form of a list of substances and drugs that appear in the Tables at the end of the General Regulation. Those tables are:
- Table 1 – Substances administered by Inhalation.
- Table 2 – Substances administered by Injection.
- Table 3 – Drug to be Prescribed.
- Table 4 – Drug to be Dispensed.
- Table 5 – Drug to be Compounded.
- Table 6 – Drug to be Sold.
Tables 3 through 6 have considerable overlap, however, they are not completely the same.
In addition to naming specific substances and drugs, the tables within the regulation may also place certain limitations on the use of the substances and drugs. Limitations may take the form of dosage limitations or routes of administration.
All substances and drugs listed in the tables are those that are deemed necessary to the current scope of practice of the profession. The College’s responsibility is to update these tables when it is necessary to do so. A change may be necessary because a drug is no longer available, or it has been made publicly available or dosage restrictions have changed.
It is not considered to be within the responsibilities of the College to contemplate an expansion to the scope of practice of the profession. Advocating to the Ontario Government to expand the scope falls within the roles of our system partners within the health regulatory field, namely the professional association and/or the educational program.
The College welcomes submissions for changes to the substances and drugs authorized to the profession at any time; however, if a submission requires a change to the scope of practice of the profession, the College will be forwarding these submissions to our system partners.
To make a submission for a change to the drugs and substances authorized to the profession, please click here.
Laboratory Testing Authorized to NDs
Laboratory testing is governed by Ontario’s Laboratory and Specimen Collection Centre Licensing Act (LSCCLA) and the regulations made under that statute. The responsibility for making changes to the Act and the regulations governing laboratory testing falls to the Ministry of Health.
The regulation made under the LSCCLA specifically authorizes NDs to perform certain point of care tests on blood in office, to collect certain specimens in office for delivery to a laboratory for testing or to requisition the collection of, and testing on certain specimens in collection centres and laboratories.
The Ministry of Health requires that the College oversee the laboratory testing authorized to NDs and to make submissions if and when changes to the authorized tests are required. This is because there is an important relationship between the administration of substances and prescribing, dispensing and compounding drugs, and the need for access to laboratory testing. For example, some drugs cannot be prescribed unless a laboratory test is conducted and the results indicate the drug can be used safely. In other circumstances, a laboratory test may be needed to monitor the on-going treatment provided to a patient to ensure its effectiveness and safety. As such, a person making a submission to authorize drugs or substances to NDs may also need to make a submission under the Laboratory Testing Consultation Process.
Additionally, laboratory tests including point of care tests can become obsolete with newer, more effective tests developed. In these instances, the College will want to know about these changes in order to ensure the most effective test for the circumstances is available to NDs in service of their patients.
The College welcomes submissions for changes to the laboratory tests authorized to the profession at any time; however, similar to the submissions of drugs and substances, if a submission requires a change to the scope of practice of the profession, the College will be forwarding these submissions to our system partners.
To make a submission for a change to the laboratory tests authorized to the profession, please click here.